Individual provider Active NPI

Roger L White PS, DC

  • Chiropractor
  • Kent, WA
National Provider Identifier
1689765133
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0001238 Issued in WA
Practice address
417 Ramsay Way
Suite 113
Kent, WA 98032-4502
Phone
(253) 859-0100
Fax
(253) 373-9600
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0001238 WA Primary

Addresses

Primary practice location

417 Ramsay Way
Suite 113
Kent, WA 98032-4502

Mailing address

417 Ramsay Way
Suite 113
Kent, WA 98032-4502
Phone (253) 859-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0001238WAMDChiropractor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1689765133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 RAMSAY WAY",
            "address_2": "SUITE 113",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980324502",
            "telephone_number": "253-859-0100",
            "fax_number": "253-373-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 RAMSAY WAY",
            "address_2": "SUITE 113",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980324502",
            "telephone_number": "253-859-0100",
            "fax_number": "253-373-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE PS",
        "first_name": "ROGER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH0001238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.